Provider Demographics
NPI:1588082929
Name:WILLIAMS, KAREN SUZANNE (APRN, RN, PHN)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:SUZANNE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APRN, RN, PHN
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:SUZANNE
Other - Last Name:GORDON-JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, PHN
Mailing Address - Street 1:2120 COUNTRY LOOP N
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33811-1313
Mailing Address - Country:US
Mailing Address - Phone:909-329-8051
Mailing Address - Fax:
Practice Address - Street 1:3030 HARDEN BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-7952
Practice Address - Country:US
Practice Address - Phone:863-687-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79295163WC1500X, 163WC0400X
CA95024541363LF0000X
FLAPRN11024505363LP2300X
CA767891163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management